Reflections of a Dietetic Intern Through the Inaugural WVU ISPP Class

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A new analysis of data from the Women’s Health Initiative now casts doubt on previous researcher’s findings that taking hormone replacement therapy (HRT) isn’t dangerous. The study, published Friday by the Journal of the National Cancer Institute, concludes that the prognosis for cancers related to hormone replacement therapy is just as dire as for other breast cancers. As a result, women who turn to the treatment are more likely to die of breast cancer than their non-hormone-taking peers.

The principal investigator for the Women’s Health Initiative and lead author of the new study stated, “You could fill a basketball arena with the women who get the disease.” “It seems like you’d want to reach a higher threshold before you take it.”

Nearly 70,000 postmenopausal women participated in randomized clinical trials as part of the Women’s Health Initiative project. The study participants who took estrogen plus progestin had higher rates of breast cancer diagnoses and of breast cancer deaths.

At the same time, more than 90,000 additional women took part in a related observational study that tracked details about their health and hormone use over an average of 11 years. Along with other observational studies, this one found that women who took hormones to treat menopause symptoms and got breast cancer were less likely to die from the illness than women who got breast cancer without taking hormones.

So he and his team identified a subset of more than 41,000 women from the observational study who more closely matched the women who took part in the randomized trial. In doing so, the researchers set aside data on women who were not using hormones when they participated in a study but had taken them in the past — a factor that had the potential to complicate the findings.

The new results fell more closely in line with the findings from the original randomized trial: Survival after breast cancer was similar for both hormone users and non-users. Tumors that arose in women who took hormones were no less deadly.

They had appeared to be, however, because women who had taken hormones years before might have already developed aggressive cancers and would not have been able to participate in the study in the first place.

Both social isolation and loneliness are associated with increased mortality, but it is uncertain whether their effects are independent or whether loneliness represents the emotional pathway through which social isolation impairs health. People who are socially isolated are more likely to die prematurely, regardless of their underlying health issues, according to a study of the elderly British population.

The research found on Monday in the Proceedings of the National Academy of Sciences,showed that when mental and physical health conditions were factored out, the lack of social contact continued to lead to early death among 6,500 men and women tracked over a seven-year period.

People were recorded as dying from natural, normal causes but, isolation did have a strong influence as well. The study also appeared to diminish the role that subjective feelings of “loneliness,” as opposed to the lack of social contact, may have on a person’s life span. Both lead to higher mortality rates, but the effects of feeling lonely is reduced once demographic and health factors are weighed in.

Regardless of the distinction, the study reinforces the need to increase social support for the elderly, even as it adds to debate over the intertwined effects of social contact and feelings of loneliness in old age. A similar look at retired Americans in 2012 reinforced multiple studies that link loneliness to numerous illnesses, including heart trouble and high blood pressure.

Both studies come as British and U.S. populations have become more solitary. People living alone compose more than a quarter of U.S households, and the proportion of Americans who said they had no one to talk to about important matters grew from 10% in 1985 to 25% in 2004.

Separating the effects of loneliness from those of isolation, however, has not been easy for those who study rates of illness and death. While isolation can be measured directly — by how many friends you have or how often you have contact with family — loneliness is more subjective, measured through survey questions about whether social needs and expectations are being met.

Anyone familiar with Henry David Thoreau knows that isolation does not necessarily lead to loneliness, while the story of Marilyn Monroe shows that a strong social life can still leave you lonely.

Last year’s report on loneliness, based on the U.S. Health and Retirement Study, showed that loneliness appeared to increase mortality risk over a six-year period, an association that could not be attributed to social relationships or health behaviors, such as smoking and drinking.

The National Institute on Aging, part of the National Institutes of Health, funded both the British study and last year’s report on U.S. retirees. Loneliness and isolation “should get lots of attention because they may be as important, as joint factors, as smoking.”However, the effect of loneliness was not independent of demographic characteristics or health problems and did not contribute to the risk associated with social isolation. Although both isolation and loneliness impair quality of life and well-being, efforts to reduce isolation are likely to be more relevant to mortality.

Americans constantly correlate a healthy lifestyle to expensive foods. This is not always the case. Yes, fresh foods, like produce for example, are normally higher in price compared to canned foods, or foods with a longer shelf-life.

Studies have shown that adopting the Mediterranean Diet helps reduce risk for cardiovascular disease, stroke, and heart attacks, amongst other chronic health disparities. The lifestyle stresses the importance of plant-based meals. One major ingredient in the diet is olive oil. The introduction of olive oil into the diet has been determined, to aid in feeling fuller long or the feeling of satiety.

Studies have also shown that an increase in plant-based meals can lead to a decrease in food insecurity. Food insecurity is defined as a lack of access to nutritional foods for at least some days or some meals for members of a household.

Researchers conducted a study to emphasize the use of simple, plant-based recipes and olive oil, following a Mediterranean diet pattern. A number of participants commented on how inexpensive a Mediterranean-style diet was. So, the study approached a local food bank about designing their study using food pantry items for the program’s recipes.

Most people, who attempt at putting together a nutritionally balanced menu for their family or household, spend the bulk of their budget on meats, poultry, and seafood. These items, specifically lower-fat versions, tend to be the most expensive items someone will see on their grocery store receipt. Low socioeconomic status families will normally purchase these items first, leaving little left in the budget for healthier fruits and vegetables.

The researcher on the study explained that if the focus of the shopper could be changed to eliminate foods that are not needed to improve health from the shopping list, a healthy diet can be more economical. Certain foods that could be crossed off that grocery store list include meats, snacks, desserts, and carbonated beverages/sodas.

The first 6 weeks of the study consisted of cooking classes where instructors prepared quick and easy plant-based recipes that incorporated ingredients like olive oil, whole grain pasta, brown rice and fruits and vegetables. The participant’s progress was tracked for 6 months after the conclusion of the cooking program.

One particular benefit for those attending the 6 week cooking class was that they were provided with groceries that contained most of the ingredients discussed by the class facilitators. The chosen ingredients provided to the participants would allow them to make 3 of the discussed recipes for their family members.

Once the classes were over, the researchers collected grocery receipts throughout the remainder of the study. Analysis of these receipts showed a significant decrease in overall purchases of meats, carbonated beverages, desserts and snacks. This was particularly interesting to the research team as they never offered instruction to the participants to avoid buying these items.

The further review of the grocery receipts showed that each household enjoyed an increase in the total number of different fruits and vegetables consumed each month. Participants cut their food spending in more than half, saving nearly $40 per week. The study also found that the reliance on food pantries decreased as well, indicating a decrease in food insecurity.

The research team also found that the cooking program had unexpected health benefits as well. Almost one-half of the participants presented loss in weight. This was not an objective in the study but, raised a few eyebrows. The study also showed an overall decrease in BMI of the participants.

Overall, this study shows that a plant-based diet, similar to the Mediterranean Diet, not only contributes to an overall improvement in health and diet. The study also highlights how a plant-based diet can contribute to decreasing food insecurity in America.

Children deficient in vitamin D at age one are more likely to have food allergies, but only if their parents are born in Australia. This is based on researcher’s findings in Melbourne, Australia.

In a study of 5000 children, researchers from the Murdoch Children’s Research Institute found that one-year-olds with vitamin D deficiency were 3 times more likely to have a food allergy than those whose levels were adequate.

Children with two or more allergies were 10 times more likely to have vitamin D deficiency, according to the study, published in the Journal of Allergy and Clinical Immunology.

The lead researcher said there was some evidence that vitamin D could play an important role in regulating a child’s immune system in the first year of life. It was likely that reduced diversity of bacteria in the gut due to increased hygiene explained the current food allergy epidemic, with vitamin D and an infant’s diet also plays a crucial factor.

Vitamin D deficiency was linked to food allergies only in children of Australian-born parents, which could be because they may have more diverse gut microbes.

”I personally think the hygiene hypothesis is very critical but in that context I think there’s a second factor, which is vitamin D and what we eat in first year of life.”

”It’s probably the two coming together at a critical moment in history which has driven this quite bizarre situation in the past 20 years where food allergies are on the rise.”

Australia has one of the highest rates of food allergy in the world, affecting more than 10% of infants.

Australia also had one of the highest rates of vitamin D deficiency, and was one of the few countries that did not fortify foods with vitamin D or provide supplements to infants.

”This study provides the first direct evidence vitamin D sufficiency may be an important protective factor for food allergy in the first year of life. We’re excited by these results, because what this suggests is there may be a modifiable factor that we can actually change and do something about to turn back the tide in the food allergy epidemic.”

Food allergies are obviously a concern to new parents and their young children. Children with food allergies are two to four times more likely to have other related conditions such as asthma and other allergies, compared with children without food allergies.

From 2004 to 2006, there were approximately 9,500 hospital discharges per year with a diagnosis related to food allergy among children under age 18 years, in the U.S. From 1997 to 2007, the prevalence of reported food allergy increased 18% among children under age 18 years.

These numbers alone, represent the alarming epidemic of food allergies that are affecting people of every age and on every continent of the world. Not only are children in danger of potential allergic reactions but, parents are the responsible parties that have to take precautions and manage their child’s everyday diet.

A new study finds people who drink more than 4 cups of caffeinated coffee a day have half the risk of dying from oral/pharyngeal cancer as people who drink it either occasionally or not at all. However, the researchers say their findings need to be confirmed by more research, and for now should just be received as good news for coffee drinkers and not be used as a reason to recommend everyone should drink 4 cups of coffee a day.

Oral/Pharyngeal Cancer

Oral/pharyngeal or mouth and throat cancer is rarely diagnosed in the early stages because symptoms usually do not appear until the cancer is advanced. Also, the symptoms can be mistaken for something else, such as toothache.

The cancer can sometimes be spotted early during a routine exam by a doctor, dentist, or dental hygienist, and some dentists and doctors suggest you look at your mouth in a mirror at least once a month to check for symptoms.

The most common symptoms are a mouth sore that fails to heal, or a pain in the mouth that doesn’t go away.

The biggest risks for developing oral/pharyngeal cancer are tobacco and alcohol use. Most people who have it are tobacco users.

Researchers Examine Link with Coffee

Previous epidemiological studies have suggested coffee drinking is linked to a reduced risk for mouth and throat cancer.

It has also been suggested that it may not be the caffeine in coffee, but the fact it is rich in antioxidants, polyphenols, and other compounds, that help prevent or slow the development of cancer.

The study gathered a wealth of lifestyle and health information on 968,432 men and women, including their tea and coffee consumption. When they enrolled on the study, none of the participants had cancer, but over the 26 years of follow up, 868 died from oral/pharyngeal cancer.

When they analyzed the tea and coffee consumption in relation to deaths from oral/pharyngeal cancer, the researchers found those participants who reported drinking more than 4 cups of caffeinated coffee a day had a 49% lower risk of death from oral/pharyngeal cancer compared to those who reported not drinking coffee at all or only an occasional cup.

Conclusion and Next Step

The researchers conclude:

“In this large prospective study, caffeinated coffee intake was inversely associated with oral/pharyngeal cancer mortality. Research is needed to elucidate biologic mechanisms whereby coffee might help to protect against these often fatal cancers.”

“We are not recommending people all drink 4 cups of coffee a day. This is just a little bit of good news for those of us who enjoy coffee.”

“There may be some other effects of coffee that may prevent people with certain conditions from drinking a lot of caffeine,” she cautions, noting that:

“This study is about just one cancer site among many. There needs to be much more consistent research before we can support the conclusion that coffee should be consumed for cancer prevention.”

The team is now planning to analyze links between coffee consumption and cancer in a more diverse population.

The Society hopes to recruit at least 300,000 adults from a range of ethnic and racial backgrounds across the US to take part in CPS-3, which aims to increase knowledge of how to prevent cancer.

There has been a lot of debate recently about the benefits and harms of coffee drinking, with more recent news suggesting the benefits probably outweigh the harms.

But researchers spreading the good news are all saying the same thing, as Hildebrand and colleagues themselves point out in this latest study: while there appear to be some health benefits to drinking coffee, there also are a few concerns, and the evidence is not solid enough to actively encourage people to go out and drink coffee.